Biologics for tendon repair.
Biologics for tendon repair.
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DOI：
10.1016/j.addr.2014.11.015
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发表时间：
2015-04
影响因子：
16.1
通讯作者：
Evans CH
中科院分区：
文献类型：
--
作者：
Docheva D;Müller SA;Majewski M;Evans CH
肌腱损伤是常见的，是骨科手术的临床挑战，主要是因为这些损伤通常对治疗反应不佳，需要长时间的康复。用于修复断裂肌腱的治疗选择包括缝线、自体移植物、同种异体移植物和合成假体。迄今为止，这些替代方案都没有提供成功的长期解决方案，并且通常修复的肌腱不能完全恢复其力量和功能。不幸的是，我们对肌腱生物学的理解远远落后于其他肌肉骨骼组织，从而阻碍了肌腱疾病新治疗方案的发展。因此，在这篇综述中，在介绍了肌腱疾病的临床意义和目前对肌腱生物学的理解之后，我们描述并批判性地评估了目前通过生物手段加强肌腱修复的策略。这些主要包括将生长因子、干细胞、天然生物材料和基因单独或联合应用于肌腱损伤部位。更深入地了解肌腱组织和细胞如何运作，结合现代分子和细胞工具的实际应用，可以在设计有效的肌腱特异性治疗和全面改善肌腱疾病管理方面提供期待已久的突破。
Tendon injuries are common and present a clinical challenge to orthopedic surgery mainly because these injuries often respond poorly to treatment and require prolonged rehabilitation. Therapeutic options used to repair ruptured tendons have consisted of suture, autografts, allografts, and synthetic prostheses. To date, none of these alternatives has provided a successful long-term solution, and often the restored tendons do not recover their complete strength and functionality. Unfortunately, our understanding of tendon biology lags far behind that of other musculoskeletal tissues, thus impeding the development of new treatment options for tendon conditions. Hence, in this review, after introducing the clinical significance of tendon diseases and the present understanding of tendon biology, we describe and critically assess the current strategies for enhancing tendon repair by biological means. These consist mainly of applying growth factors, stem cells, natural biomaterials and genes, alone or in combination, to the site of tendon damage. A deeper understanding of how tendon tissue and cells operate, combined with practical applications of modern molecular and cellular tools could provide the long awaited breakthrough in designing effective tendon-specific therapeutics and overall improvement of tendon disease management.